Rome IV Diagnostic Questionnaire Complements Patient Assessment of Gastrointestinal Symptoms for Patients with Gastroparesis Symptoms

Jehangir, Asad; Parkman, Henry P.

doi:10.1007/s10620-018-5125-1

Cited by 23 publications

(39 citation statements)

References 36 publications

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“…Patients with gastroparesis typically report a variety of gastrointestinal (GI) symptoms including nausea, vomiting, early satiety, post-prandial fullness, and abdominal pain [6]. The symptoms of Gp may be indistinguishable from functional dyspepsia and chronic nausea and vomiting syndrome without assessment of gastric emptying [6]. The causes of abdominal pain in Gp patients can be multifactorial with somatic, visceral and neuropathic components [9].…”

Section: Symptoms Of Gastroparesismentioning

confidence: 99%

“…The National Institute of Diabetes and Digestive and Kidney Diseases -Gastroparesis Consortium studies on patients with symptoms of Gp found a number of patients with symptoms of Gp but normal gastric emptying, termed chronic unexplained nausea and vomiting (CUNV) [60]. Over a third of patients with symptoms of Gp have normal total gastric emptying suggesting that factors, in addition to slow gastric emptying, also appear to be important in the pathogenesis of Gp symptoms [6]. Assessment of regional gastric retention and fundic accommodation during GES may provide additional information regarding the pathogenesis of dyspeptic symptoms.…”

Section: Role Of Gastric Emptying In Symptoms Of Gastroparesismentioning

confidence: 99%

“…The two most common subtypes of Gp are idiopathic Gp and diabetic Gp [6]. Delayed gastric emptying has been found to occur in up to 40% of patients with type 1 diabetes mellitus and 20% of patients with type 2 diabetes mellitus [3,7].…”

Section: Introductionmentioning

confidence: 99%

“…Delayed gastric emptying has been found to occur in up to 40% of patients with type 1 diabetes mellitus and 20% of patients with type 2 diabetes mellitus [3,7]. The third most common subtype is postsurgical Gp [6]. In the past, gastric ulcer resection surgery, particularly with vagotomy was the surgery most commonly associated with Gp [8].…”

Section: Introductionmentioning

confidence: 99%

“…In the past, gastric ulcer resection surgery, particularly with vagotomy was the surgery most commonly associated with Gp [8]. Today, the more common surgical procedures associated with postsurgical Gp appear to be fundoplication and bariatric surgeries [6]. In atypical cases patients can develop Gp symptoms associated with connective tissue and neuromuscular diseases such as Scleroderma, Systemic Lupus Erythematosus, Ehlers Danlos Syndrome, Sjögren's Syndrome, Parkinson's disease, and Myasthenia Gravis [6,8].…”

Section: Introductionmentioning

confidence: 99%

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Role of Gastric Emptying in Symptoms of Gastroparesis

Jehangir

Parkman

2019

Gastrointestinal Disorders

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The symptoms of gastroparesis, such as nausea, vomiting, postprandial fullness, early satiety and abdominal pain, frequently impair the quality of life of the affected individuals. The diagnosis of gastroparesis is made after structural etiologies are ruled out and an assessment of gastric function shows delayed gastric emptying. The role of the delay in gastric emptying in the pathogenesis of symptoms of gastroparesis has been debated, with some studies suggesting an association between delayed gastric emptying and the upper gastrointestinal symptoms, while others do not. The recent literature supports the importance of using reliable methods to assess gastric emptying, as delay in gastric emptying measured on a reliable test (4-h scintigraphy or breath test) is associated with the severity of upper gastrointestinal symptoms. In addition to measuring total gastric emptying, evaluation of regional gastric retention in the proximal and distal stomach and whole gut transit to assess small intestinal and colonic transit may provide additional useful information in patients with more generalized symptoms of gastrointestinal dysmotility.

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Section: Symptoms Of Gastroparesismentioning

confidence: 99%

Section: Role Of Gastric Emptying In Symptoms Of Gastroparesismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Role of Gastric Emptying in Symptoms of Gastroparesis

Jehangir

Parkman

2019

Gastrointestinal Disorders

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Preliminary data that psychological treatment and baseline anxiety are associated with a decrease in postprandial fullness and early satiation for individuals with bulimia nervosa and related other specified feeding or eating disorder

Forney,

Burton Murray,

Himawan

et al. 2023

Intl J Eating Disorders

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ObjectiveGastrointestinal symptoms, particularly postprandial fullness, are frequently reported in eating disorders. Limited data exist evaluating how these symptoms change in response to outpatient psychological treatment. The current study sought to describe the course of postprandial fullness and early satiation across psychological treatment for adults with bulimia nervosa and related other specified feeding or eating disorders and to test if anxiety moderates treatment response.MethodsSecondary data analysis was conducted on questionnaire data provided by 30 individuals (80% white, M(SD)age = 31.43(13.44) years; 90% female) throughout treatment and six‐month follow‐up in a pilot trial comparing mindfulness and acceptance‐based treatment with cognitive‐behavioral therapy for bulimia nervosa. Participants completed items from the Rome IV Diagnostic Questionnaire for Adult Functional Gastrointestinal Disorders and the State Trait Anxiety Inventory.ResultsPostprandial fullness and early satiation both significantly decreased over time (ds = 1.23–1.54; p's < .001). Baseline trait anxiety moderated this outcome, such that greater decreases were observed for those with higher baseline anxiety (p = .02).DiscussionResults extend prior work in inpatient samples by providing preliminary data that postprandial fullness and early satiation decrease with outpatient psychological treatment for bulimia nervosa. Baseline anxiety moderated this effect for postprandial fullness. Future work should replicate findings in a larger sample and test anxiety as a mechanism underlying postprandial fullness in eating disorders.Public SignificanceThe current study found that common gastrointestinal symptoms (postprandial fullness and early satiation) decrease over the course of outpatient psychotherapy for adults with full and subthreshold bulimia nervosa. Postprandial fullness decreased more across time for those high in anxiety.

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United European Gastroenterology (UEG) and European Society for Neurogastroenterology and Motility (ESNM) consensus on gastroparesis

et al. 2021

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Background: Gastroparesis is a condition characterized by epigastric symptoms and delayed gastric emptying (GE) rate in the absence of any mechanical obstruction.The condition is challenging in clinical practice by the lack of guidance concerning diagnosis and management of gastroparesis.Methods: A Delphi consensus was undertaken by 40 experts from 19 European countries who conducted a literature summary and voting process on 89 statements. Quality of evidence was evaluated using grading of recommendations assessment, development, and evaluation criteria. Consensus (defined as ≥80% agreement) was reached for 25 statements. Results:The European consensus defined gastroparesis as the presence of symptoms associated with delayed GE in the absence of mechanical obstruction. Nausea and vomiting were identified as cardinal symptoms, with often coexisting postprandial distress syndrome symptoms of dyspepsia. The true epidemiology of gastroparesis is not known in detail, but diabetes, gastric surgery, certain neurological and connective tissue diseases, and the use of certain drugs recognized as risk factors. While the panel agreed that severely impaired gastric motor function is present in these patients, there was no consensus on underlying pathophysiology.The panel agreed that an upper endoscopy and a GE test are required for diagnosis.Only dietary therapy, dopamine-2 antagonists and 5-HT 4 receptor agonists were considered appropriate therapies, in addition to nutritional support in case of severe weight loss. No consensus was reached on the use of proton pump inhibitors, other classes of antiemetics or prokinetics, neuromodulators, complimentary, psychological, or more invasive therapies. Finally, there was consensus that gastroparesis adversely impacts on quality of life and healthcare costs and that the long-term prognosis of gastroparesis depends on the cause.This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

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Rome IV Diagnostic Questionnaire Complements Patient Assessment of Gastrointestinal Symptoms for Patients with Gastroparesis Symptoms

Cited by 23 publications

References 36 publications

Role of Gastric Emptying in Symptoms of Gastroparesis

Role of Gastric Emptying in Symptoms of Gastroparesis

Preliminary data that psychological treatment and baseline anxiety are associated with a decrease in postprandial fullness and early satiation for individuals with bulimia nervosa and related other specified feeding or eating disorder

United European Gastroenterology (UEG) and European Society for Neurogastroenterology and Motility (ESNM) consensus on gastroparesis

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